title: Hepatocellular carcinoma after sustained viral response to interferon and ribavirin therapy in cirrhosis secondary to chronic hepatitis C.
abstract: OBJECTIVE
  To determine the frequency of development of hepatocellular carcinoma in patients with chronic liver disease secondary to hepatitis C who had achieved sustained virological response with Interferon and Ribavirin therapy.
  
  
  METHODS
  Retrospective descriptive study.
  
  
  METHODS
  Shifa International Hospital, Islamabad, Pakistan, from January 2007 to January 2012.
  
  
  METHODS
  Hepatitis C related chronic liver disease patients who were treated with interferon and ribavirin, after they achieved sustained virological response, they were followed for a mean of 42 ± 17 months. During this time, development of hepatocellular carcinoma was ascertained. All underwent surveillance with alpha-feto-protein and ultrasonography every 6 months.
  
  
  RESULTS
  Out of the 58 patients who had achieved sustained virological response, 3 developed hepatocellular carcinoma after a mean follow-up of 38 ± 14 months. It was multifocal in 2 cases and was single lesion in the 3rd. Two patients ultimately died, one with upper GI bleeding and the other with hepatic encephalopathy, while 3rd patient with single lesion is still surviving.
  
  
  CONCLUSIONS
  Three out of 58 patients of hepatitis C related chronic liver disease developed hepatocellular carcinoma during follow-up in patients who had achieved sustained virological response. These patients need closer follow-up, for development of complications, even if they have achieved sustained viral response.
authors.affiliation: Department of Gastroenterology / Medicine, Shifa International Hospital, Islamabad.
authors.forename: Nasir
authors.initials: N
authors.lastname: Khokhar
authors.forename: Tariq Khan
authors.initials: TK
authors.lastname: Niazi
authors.forename: Muhammad Omar
authors.initials: MO
authors.lastname: Qureshi
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D015994:Incidence; D007372:Interferons / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D008113:Liver Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; D012254:Ribavirin; D007372:Interferons